Coronavirus disease 2019 and the cardiologist

Abstract

Purpose of reviewThere continues to be extensive clinical and epidemiological data to suggest that coronavirus disease 2019 (COVID-19) infection is associated with numerous different types of cardiac involvement. Recent findingsMyocardial injury has been reported in over 25% of patients hospitalized due to COVID-19 infection and is not only associated with a worse prognosis but with higher mortality, approaching 40%. Currently proposed mechanisms of myocardial injury include direct viral infection, cytokine storm, endothelial inflammation, demand ischemia, interferon-mediated response and stress cardiomyopathy. COVID-19 infection is associated with new-onset arrhythmias and heart failure regardless of history of previous cardiovascular disease. Echocardiographic findings can be useful to predict mortality in COVID-19 patients and cardiac MRI is an effective tool to both assess COVID-19 induced myocarditis and to follow-up on cardiac complications of COVID-19 long-term. Although there is an association between COVID-19 vaccination and myocarditis, pericarditis or arrhythmias, the risk appears lower when compared to risk attributable to the natural infection. SummaryPatients with cardiovascular disease are not only more likely to suffer from severe COVID-19 infection but are at increased risk for further complications and higher mortality. Further data compilation on current and emerging treatments of COVID-19 will have additional impact on cardiovascular morbidity and mortality of COVID-19 infection.

Interaction of COVID-19 With Common Cardiovascular Disorders

“…Evidence of myocardial injury, irrespective of the presence of prior cardiovascular disease, significantly increased rates of morbidity and mortality. 41,[48][49][50][51][52][53][54][55][56][57] During the interval of 3 years, extensive work has aimed to understand the pathophysiologic basis for this injury, and to extrapolate how injury at the level of the viral particle and endothelial cell or cardiac myocyte begets injury at the level of the cardiovascular organ system as a whole, with particular attention paid to venous and arterial thrombosis, arrhythmias, acute coronary syndromes, myocarditis, and systolic dysfunction. 24,25,50,[58][59][60][61][62][63][64][65][66][67][68]…”